Retiree Health Plans

Non-Medicare Eligible Retirees

CareFirst logo
www.carefirst.com/frederick

Frederick County Public Schools (FCPS) retiree health plan includes both vision and prescription coverage. Your plan is on a calendar year basis January 1st through December 31st. Your open enrollment is held in October of each year.

CareFirst Medical Plan

In-network — Selecting a physician or health care provider within the CareFirst’s large local and national network means maximum coverage and lower out-of-pocket expenses. Copayments are charged for eligible services, and referrals are not required for specialty services.

Out-of-network — Higher deductibles are required and you must file claims for reimbursement of 80% of eligible expenses. Employees have a $200 deductible and an annual out-of-pocket maximum of $1,250. Family coverage requires a $400 deductible and an annual out-of-pocket maximum of $2,500.

How to find a network provider through CareFirst

For more detailed information, please see the Summary Plan Description.

Medicare Eligible Retirees

You must pay the Medicare Part B Annual Deductible of $226 as of 2023, (indexed annually), prior to Carefirst paying any of your medical bills.  Medicare will pay first and then CareFirst will pay second. In most cases, the remaining balances should be paid by CareFirst if you are using in-network Medicare providers. To make sure that your Medicare bills are sent to CareFirst automatically, you can call CareFirst and request that a “crossover” form be placed on file on your behalf. This will assist in the claims processing for you.

CareFirst Resources

Primary Care Provider (PCP)

Establishing a relationship with a primary care provider is the best way to receive consistent, quality care. Except for emergencies, your PCP should be your first call when you require medical attention. Your PCP may be able to provide advice over the phone or fit you in for a visit right away.

Searching for provider call 1-866-386-2043 or visit www.carefirst.com/frederick

FirstHelp—free 24-hour nurse advice line

Call 800-535-9700 anytime to speak with a registered nurse. Nurses can provide you with medical advice and recommend the most appropriate care.

CareFirst Video Visit

See a doctor 24/7 without an appointment! You can consult with a board-certified doctor on your smartphone, tablet or computer. Doctors can treat a number of common health issues like flu and pinkeye. Visit carefirst.com/frederick for more information.

Blue Distinction® Specialty Care

You may be eligible to have your copays waived for certain conditions during your treatment plan by using a Blue Distinction Center. To find out more contact CareFirst directly at 1-866-386-2043 to determine if you qualify.

The hospital you select can have a direct impact on the care you receive and your procedure results, but finding the right facility can sometimes be a challenge. The Blue Distinction Specialty Care recognition program identifies health care facilities with proven expertise in delivering specialty care. There are two designations:

  • Blue Distinction Centers - Health care facilities recognized for expertise in delivering specialty care.
  • Blue Distinction Centers+ - Health care facilities recognized for expertise and cost efficiency in delivering specialty care.

Search for Blue Distinction Centers® using CareFirst’s Find A Doctor. directory when you have specialty care needs, such as bariatric, cardiac, transplant, spine, or knee or hip replacement surgery, in the CareFirst Service Area (Maryland, the District of Columbia and Northern Virginia). These facilities have demonstrated expertise in delivering clinically proven specialty health care. Taking advantage of Blue Distinction Centers® to have a better outcome and save money!

To find a Blue Distinction Center® outside of the CareFirst service area, visit the BlueCross BlueShield National Doctor and Hospital Finder.

CareFirst Incentive Rewards

CareFirst offers you the opportunity to improve your health and earn rewards through its incentive Blue Rewards program. You can set your own challenges and healthy goals and start earning now.  Begin by completing a Personalized Health Assessment.

CareFirst Wellness Programs

Whether you're trying to lose weight, improve your well-being, or simply live a healthier lifestyle, CareFirst offers tools and resources to help you reach your goals.

To access these wellness programs, log in to My Account at www.carefirst.com/frederick.

Innergy® Healthier Weight program

If you are age 18 or older, have a BMI of 30 or greater and are looking to lose weight, the Innergy program can help. Innergy offers a personalized solution for long-term weight loss and helps participants reach a healthier weight. To get started, select the Innergy icon and complete the registration process.

QuitNet® Tobacco Cessation program

Quitting smoking and other forms of tobacco can lower your risk for many serious conditions from heart disease and stroke to lung cancer. QuitNet’s expert guidance, support and wealth of tools make quitting easier than you might think. To get started, simply click on the QuitNet icon and complete the registration process.

Financial Well-Being™, powered by Dave Ramsey

Financial expert Dave Ramsey will show you how to take small steps toward big improvements in your financial situation. Whether you want to stop living paycheck to paycheck, get out of debt, or send a child to college, the Financial Well-Being program can help. To get started, select the Financial Well- Being icon and complete the registration process.

Mental Health Support

Well-being for mind and body

Living your best life involves good physical and mental health. Emotional well-being is important at every stage in life, from adolescence through adulthood.

It’s common to face some form of mental health challenge during your life, caused by a variety of reasons, many of which are beyond your control. Some of the contributing factors include:

  • Biology, such as genes, brain chemistry, physical illness or injury
  • Life experiences, such as trauma, tragedy or abuse
  • Family history

When mental health difficulties arise for you or a loved one, remember you are not alone. Help is available and feeling better is possible.

Through CareFirst BlueCross BlueShield, CareFirst BlueChoice Inc. (CareFirst), you have access to specialized services and programs to help you get well, if and when you need assistance related to:

  • Depression
  • Drug or alcohol dependence
  • Stress
  • Work-life balance
  • Eating disorders

If you or someone close to you needs support or help making an appointment, call 800-972-0716 or visit www.carefirst.com/frederick.

In addition, you will find FCPS has available to you services through the Employee Assistance Program (EAP) that will provide you several free visits for you or your dependents.  Find out more about the EAP program here.